诊断年龄对风湿性多肌痛临床特征的影响:68例患者的单中心回顾性队列研究  

Effects of diagnosis age on clinical manifestations of polymyalgia rheumatica:A single center retrospective cohort study on 68 patients

作　　者：林长艺[1] 宋明辉 吴培埕 Lin Changyi;Song Minghui;Wu Peicheng(Department of Rheumatology and Immunology,Sanming First Hospital Affiliated to Fujian Medical University,Sanming 365000,China)

机构地区：[1]福建医科大学附属三明市第一医院风湿免疫科,福建三明365000

出　　处：《临床荟萃》2022年第7期612-615,共4页Clinical Focus

摘　　要：目的比较不同诊断年龄(>60岁和≤60岁)风湿性多肌痛(polymyalgia rheumatica,PMR)患者的临床特征。方法回顾性分析2013年1月至2019年12月我院诊治的风湿性多肌痛患者68例,依据诊断年龄,分为PMR≤60岁组(24例)和PMR>60岁组(44例),比较两组临床资料(一般资料、临床表现、实验室指标、治疗反应)。结果两组病程、是否吸烟差异均无统计学意义(P>0.05),与PMR≤60岁组相比,PMR>60岁组女性占比更高(P<0.05);两组在体重减轻、发热、肩胛带肌痛、骨盆带肌痛、颈痛、腰痛、晨僵方面比较,差异均无统计学意义(P>0.05);两组乳酸脱氢酶(LDH)水平差异无统计学意义(P>0.05),与PMR≤60岁组相比,PMR>60岁组血沉(ESR)、C反应蛋白(CRP)水平较高,血红蛋白(Hb)水平较低(均P<0.05);所有的患者均接受一线糖皮质激素治疗,两组单独使用糖皮质激素占比、糖皮质激素累积剂量差异均无统计学意义(P>0.05),与PMR>60岁组相比,PMR≤60岁组复发占比较少(P<0.05)。结论与诊断年龄>60岁的PMR患者相比,诊断年龄≤60岁的患者复发风险较低,更积极的糖皮质激素治疗是不合理的。Objective To compare the clinical manifestations of polymyalgia rheumatica(PMR)patients with different ages at diagnosis(>60 years and≤60 years).Methods Sixty eight patients with PMR who were diagnosed and treated in our hospital from January 2013 to December 2019 were retrospective analyzed.The patients were divided into the PMR≤60 years old group(24 cases)and PMR>60 years old group(44 cases)based on different diagnosis age.The clinical data(general data,clinical features,laboratory indicators,treatment response)of two groups were compared.Results The differences in the course of disease and smoking between two groups weren’t statistically significant(P>0.05),and the proportion of women in the PMR>60 years old group was higher compared with that in the PMR≤60 years old group(P<0.05).The differences in the weight reduction,fever,shoulder girdle myalgia,pelvic girdle myalgia,neck pain,low back pain and morning stiffness weren’t statistically significant between groups(P>0.05);the difference in the level of lactate dehydrogenase(LDH)between groups wasn’t statistically significant(P>0.05).The level of the PMR>60 years old group had higher level of erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)and lower hemoglobin(Hb)level when compared with such indicators in the PMR≤60 years old group(P<0.05 at all points).All patients received the first-line glucocorticoid therapy,the differences in the proportion of glucocorticoids administered exclusively and cumulative doses of patients between two groups weren’t statistically significant(P>0.05).The proportion of recurrence in the PMR≤60 years old group was less when compared with that in the PMR≤60 years old group,(P<0.05).Conclusion Patients with the age at diagnosis≤60 years old have a lower risk of recurrence compared with PMR patients with the age at diagnosis>60 years,and more aggressive glucocorticoid therapy is unreasonable.

关 键 词：风湿性多肌痛 年龄 糖皮质激素类 

分 类 号：R593.21[医药卫生—内科学]